by Stanley Weiss, DDS, FAGD, MS
Is the glass in the picture half full or half empty? It's all in your perception! How your patients perceive you and how you perceive yourself are vital elements in the success of your practice.
Is your glass half full ... or half empty? It's all in your perception! Perception sets the tone for how we view life, our practice, our staff, and our family. It can help us or hinder us. Perception is why we all do not see or hear the same thing.
What do we mean by perception? A simple definition might be that it is the way we interpret data. A slightly more involved definition is to term it an interpretation of what we have seen and/or heard, based on the sensory information we have received. Perception is one of the foundations of communication, relationships, and behavioral actions, reactions, and inactions.
From the unique perspective that I have as a dentist, psychotherapist, and educator, I have come to the realization that few individuals or couples have the requisite communication and relationship skills essential to initiate and sustain a loving, intimate relationship in their personal lives. A corollary to this is that our deficits in these important areas carry over into our professional lives.
Communication is very important in our dental careers. It is a necessary ingredient in establishing and maintaining relationships of any kind. I passionately believe that a major component of practicing dentistry successfully is establishing and maintaining relationships with our patients.
As a dentist, I never thought that I was in the "tooth" business. I always thought of myself as in the "relationship" business. Communication and relationship skills are what keep patients coming back to our practices. Mastery of these areas keeps your patients happy, prevents them from filing malpractice lawsuits if a problem occurs, and establishes the trust necessary for patient acceptance of our treatment plans. In addition, a good relationship with your staff is equally important in fostering an efficient, pleasant, and productive environment that patients will enjoy.
The only mechanical skill that approaches the significance and impact of communication and relationship skills is your injection technique. However, learning how to talk with — and relate to — patients will enhance your practice and produce income exponentially in a way that good mechanical skills never will.
What patients relate to are our interpersonal skills — our abilities to communicate, to show we care, and to be humanistic, kind, friendly, and humorous. Basically, patients have no clue about what we are doing in their mouths. With the exception of directly-placed composites, we do not make the laminates or crowns — our laboratories do. A patient has no idea if the preparation is proper, if all of the caries has been removed, or if the laminate or crown fits well.
Many studies have shown that patients do not rate clinical skills of their health-care professionals as very important. For example, in a study done in 1997 by Booz, Allen, and Hamilton, an international management-consulting company, patients rated the characteristics they valued the most in their health-care professionals. Clinical competence was rated No. 14 on the list. Their top three priorities were: 1) waiting time (or the lack thereof!), 2) friendliness and approachability, and 3) physical surroundings.
Communication and relationship skills are important in every area of our lives — professional, personal, social, and family. If you can enhance these skills, it will benefit all aspects of your life. Good communication and relationship skills are essential because our everyday lives are filled with interactions with other human beings.
Think about your own experience when you go to a dentist, physician, attorney, a retail store, or talk with a stranger on the phone. Are you not more comfortable and at ease with someone who is warm and friendly ... someone who exudes a feeling of caring and concern?
If you were in need of a personal consultant, you would never select someone who did not possess adequate communication and relationships skills and who was unable or unwilling to answer your questions. For this type of one-on-one consultation to work, you must feel comfortable with and trust each other.
Just as "location, location, location" is essential to business success, so "communication, communication, communication" is essential to building successful relationships.
Now, let's look at some of the factors involved in understanding what perception is and how it affects our lives.
The impact of perception
People see things differently as a result of their backgrounds (values, attitudes, ethics, and morals). Perception is different for each individual. Your perceptions are unlike that of any other human being, including your spouse, friends, parents, staff, patients, and your own children.
Perceptions are neither right nor wrong. They just are what they are. Your perceptions are formed by the way you see things, and they are unique to you. The way you were parented, the role models you had in your childhood, and your early childhood experiences all play a role in creating your perceptions. You react in the way that only you can react, based upon your perceptions. Therefore, perception, as with all other behavior, is developed, molded, and nurtured in early childhood.
By the time you are an adult, your personality and the way you perceive things are fully developed and quite resistant to change. How you handle every aspect of your life is determined by your perception of the people and experiences that populate it.
For example, if I am in the office all day, I will ask my patients, "How's the weather outside?" If I ask 10 patients, I will get 10 different answers. Does that mean that some of them are right and some of them are wrong? Of course not! In a sense, they are all correct, because what they tell me is their perception of how the weather affects their own comfort or discomfort.
Another example is how people will have different perceptions of — and reactions to — a movie, song, work of art, a book, a teacher, a dentist, or a politician. Obviously, they are all "right" ... or so they believe! What about a professional critic? When critiquing a movie, play, art, or book, is the critic "right" just because he or she has been labeled as a "professional critic?"
If your opinion differs from the professional critic, is your opinion wrong because you do not have that title? No! Only the perception of that individual as a "professional critic" gives more credence to his or her opinion in the eyes of some people.
This explains why I can give an injection to one patient, and that patient does not feel anything. Many of my patients have told me that my injections are painless. Some even ask me when I am going to start the injection ... and I'm already finished with it! One man told me that I was an artist at giving injections.
Another patient repeatedly called me a liar, because prior to every injection I give, I tell the patient that he or she will feel it a little ... and he never did! So, all these positive comments really make me feel good about myself, my gentleness, and my injection technique.
Then the next patient comes in ... and carries on like he is being tortured as I give him an injection! He is screaming, crying, and pulling away from me. I ask myself how, in the space of a few minutes, I have gone from conducting myself like Mother Teresa to becoming a vicious Saddam Hussein? Did I say to myself that I liked the first few patients that day, so I'm going to give them really easy injections, but I disliked the next guy, so I'm going to hurt him?
I don't think I made that distinction. I think my injection technique is a constant, no matter who the patient is.
Then what changes? What is the variable? It is the individual patient and that person's perception of the injection.
Who would you mug?!
Years ago, a study was done at Rahway State Prison in New Jersey that involved showing a number of inmates movies (before videotape) of people walking down the street. The inmates were asked to record which of these people they would attempt to attack and rob, and which they would leave alone.
The determining factor was the inmate's perception of the individual's personality, based upon that person's body language. The people they would attack were those who walked slowly, in a meandering way, with their heads down. The potential victims did not make eye contact with other people and seemed to be meek, preoccupied, or dejected, with the weight of the world on their shoulders. The inmates viewed these people as individuals who would not fight back. On the other hand, the people they wouldn't attack were those who walked with a purposeful stride with their heads erect. These individuals did make eye contact with others, and they were alert and cognizant of their surroundings. The inmates felt these people could not be taken by surprise and would fight back if attacked.
Now let's go back to dentistry and our patients. What about the parent who brings a child into the operatory for dental work? The child seems to be comfortable and happy. You explain to the child what you are going to do. The parent then says to the child, "It's not going to hurt!" or "Don't be frightened!" or "Do you want to hold my hand?" What just happened? The parent, unknowingly, imparted his or her fear of dentistry to the child, who otherwise was not apprehensive. Now, unfortunately, the "pinch" of the needle may well be interpreted as pain.
What about the parents who are so solicitous of their children that they hold the child's hand or leg during dental treatment, saying, "It's going to be alright!"? This gets the child thinking about why Mommy or Daddy — or both parents — are acting this way, and then the child begins to worry about what is going to happen. This creates fear in the child ... a child who previously had no fear of dentistry. All of this was due to the parents' perception of their own childhood dental experiences as something fearful.
What about the situation that occurs when you walk into an operatory to give a female patient a dental exam, and her 10-year-old son, who is with her that day, is being disruptive. The mother gives her son a strong look of disapproval and says, "If you don't behave, I'm going to have the dentist rip all of your teeth out of your mouth!" Now there's a boy who will look forward to future dental visits!
Our individual perceptions are so unique — and, frequently, so invalid — that many states have passed legislation barring conviction of a person accused of committing a crime based solely on the visual identification of one individual. These laws have been passed because later DNA evidence has repeatedly proven that the perception of a victim in identifying an accused perpetrator is frequently incorrect. People sometimes see or hear what they want to see or hear. It has nothing to do with the actual reality.
Let's go back to our world of dentistry. If your dental assistant speaks harshly to you, does it mean that she is angry with you, doesn't like you, is unfriendly, or that you did something wrong? Does it mean that she feels underappreciated, unhappy, or unproductive? Or could her harsh words indicate something entirely different ... that she is having a bad day, that her car broke down on the way to work, that she and her boyfriend had a fight, or that a family member is seriously ill? One group of perceptions would indicate a personal problem with you, while the other set has nothing to do with you personally. But for one set of perceptions to be valid, the other set must be invalid.
So what do you do to verify the validity of your perceptions? You do what is called perception-checking. Perception-checking has three parts.
1. State your observation, such as, "I noticed that you spoke harshly to me."
2. Express your interpretation of the situation, such as "The message I got was that you are unhappy with me."
3. Ask for clarification — i.e., "Was that the message you intended to send?"
When you do perception-checking — as with all other forms of communication — be specific, avoid labeling, and do not use inflammatory words such as "always," "never," "worthless," "unprofessional," or "lazy."
Finally, never make assumptions! They can be fatal! You will be wrong more times than you are right. Misinterpretations harm relationships — of any kind. Remember, you are a unique individual and you will never see things in the exact same way as someone else. Your perceptions become the reality you create.
Although this article is not about "How To Build a Million Dollar Practice," I sincerely believe that enhancing your communication and relationship skills can catapult you toward that goal. Achieving excellence with these skills begins with examining your own perceptions and their validity. Remember, we do not see things as they are; we see things as we are.
Each of us makes judgments based upon our individual perceptions of reality. That perception may or may not be an accurate assessment of the situation.
For example, suppose there is an employee at a particular company. We'll call him John Doe. John is always the first person to arrive at work and the last one to leave. What do you think this means? Why do you think he is always the first to arrive and the last to go home? What is your interpretation of his behavior? Think about it before answering the question.
There actually are several interpretations that could be made about John's behavior, and they all would be based upon individual perceptions. The fact that John always arrives early and always leaves late could mean that:
1.John Doe is a very dedicated worker.
2.John Doe is in a car pool and must go to work and come home when his fellow car-poolers do.
3.John Doe could suffer from poor time management and needs extra time to complete his work.
4.John Doe is in a terrible marriage or other relationship, and wants to spend as much time as possible away from home.
5.John Doe is a very aggressive employee and is attempting to climb up the corporate ladder.
6.John Doe is a brown-noser trying to impress the boss.
Before attempting to verify your own perceptions of John Doe's behavior, you should question your own interpretation of his behavior. Ask yourself a few questions, such as:
1. What is the evidence to support my perception/interpretation?
2.What is the evidence to the contrary?
3.Do John Doe's actions or communication seem to validate the motive that I am assigning to him?
4.Is there an alternative explanation for his behavior?